Psychosocial Integrity NCLEX Questions

Extract:

Question 1 of 5

A client who is in labor has human immunodeficiency virus (HIV) and states to the nurse, 'I know I will have a sick-looking baby.' Which appropriate therapeutic response should the nurse make?

Correct Answer: C

Rationale: Option 3 is the most therapeutic response, and it will elicit the best information. It addresses the therapeutic communication technique of paraphrasing. Option 3 also is an open-ended response that will provide an opportunity for the client to verbalize her concerns. Parents need to know that their baby will not look sick from HIV at birth and that there may be a period of uncertainty before it is known whether the baby has acquired the infection. Options 1 and 2 provide false reassurances. The client should not be told that there is no reason to worry.

Question 2 of 5

The nurse is caring for a client with end-stage kidney disease and multiple organ failure. Which action by the nurse indicates an understanding of end-of-life care? Select all that apply.

A. The nurse explains signs and symptoms that indicate death is near. B. The nurse explains to the client and family what to expect during the final phase of the illness. C. Cultural beliefs are acknowledged, but priority is placed on life-lengthening treatment options. D. The nurse avoids talking to the client about impending death to avoid upsetting him and the family. E. The nurse asks the client and family what their goals and wishes are regarding care, pain management, and emergency resuscitation.

Correct Answer: A,B,E

Rationale: Explaining signs of nearing death (
A), what to expect (
B), and discussing goals/wishes (E) support informed, compassionate end-of-life care. Prioritizing life-lengthening treatments (
C) disregards palliative focus, and avoiding death discussions (
D) hinders open communication.

Question 3 of 5

A community health nurse visits a recently widowed retired military client. When the nurse visits, the ordinarily immaculate house is in chaos, and the client is disheveled and has an alcohol type of odor on his breath. Which therapeutic statement should the nurse make to the client?

A. I can see this isn't a good time to visit. B. You seem to be having a very troubling time. C. Do you think your wife would want you to behave like this? D. What are you doing? How much are you drinking and for how long?

Correct Answer: B

Rationale: The therapeutic statement is the one that helps the client explore his situation and express his feelings. Reflection, by telling the client that the nurse feels that he is experiencing a troubled or difficult time, is empathic, and it will assist the client with beginning to ventilate his feelings. Option 1 uses humor to avoid therapeutic intimacy and effective problem-solving. Option 3 uses admonishment and tries to shame the client, which is not therapeutic or professional. This social communication belittles the client, will likely cause anger, and may evoke 'acting out' by the client. Option 4 uses social communication.

Question 4 of 5

A client with superficial varicose veins states to the nurse, 'I hate these things. They're so ugly. I wish I could get them to go away.' Which therapeutic response would be most appropriate for the nurse to make to the client?

A. You should try sclerotherapy. It's great. B. What makes you so upset about having ugly varicose veins? C. What have you been educated about varicose veins and their management? D. I understand how you feel, but you know, they really don't look all that bad.

Correct Answer: C

Rationale: The client expressing distress about physical appearance has a risk for an altered body image. The nurse assesses the client's knowledge and self-management of the condition as a means of empowering the client and helping him or her adapt to the body change. Options 1 and 4 are not therapeutic. Option 2 focuses only on the cosmetic aspect of varicose veins.

Question 5 of 5

A 28-year-old woman is recovering from her third consecutive spontaneous abortion in 2 years. Which is the most therapeutic nursing intervention for this client at her follow-up appointment?

A. Focusing on the client's physical needs B. Encouraging the client to verbalize her feelings about the loss C. Reminding the client that she will be able to become pregnant again D. Encouraging the client to think of herself, her husband, and their future

Correct Answer: B

Rationale: The most therapeutic nursing intervention for a client recovering from multiple spontaneous abortions is to encourage the client to verbalize her feelings about the loss. This allows the client to express and process her emotions, facilitating the grieving process and emotional healing. Focusing solely on the client's physical needs, as in choice A, overlooks the importance of addressing the emotional aspect of the client's experience.
Choice C, reminding the client that she will be able to become pregnant again, fails to acknowledge the current loss and may minimize the client's feelings of grief.
Choice D, encouraging the client to think of herself, her husband, and their future, does not directly address the client's immediate emotional needs related to the recent loss.
Therefore, choice B is the most appropriate intervention to support the client in coping with her emotional distress.

Psychosocial Integrity NCLEX Questions - Nurselytic

Nurselytic

NCLEX-RN

NCLEX-RN